Obsessive Compulsive Disorder (OCD)

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The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated. OCD symptoms can range from mild to severe with some sufferers spending an hour or so a day engaged in obsessive-compulsive thinking and behaviour, while for others the condition can completely take over their life.

Obsessive Compulsive Disorder (OCD) affects children and adolescents, as well as adults. It is estimated that around 12 in every 1,000 people in the UK are affected by the condition. OCD typically starts to significantly interfere with a person's life during early adulthood; although roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the lifespan.

It is not clear exactly what causes OCD, although a number of factors have been suggested. In some cases the condition may run in families, and may be linked to certain inherited genes that affect the brain's development. Brain imaging studies have shown the brains of some people with OCD can be different from the brains of people who do not have the condition. For example, there may be increased activity in certain areas of the brain, particularly those that deal with strong emotions and the responses to them. Studies have also shown people with OCD have an imbalance of serotonin in their brain. Serotonin is a chemical the brain uses to transmit information from one brain cell to another.

OCD is essentially an anxiety disorder characterised by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviours aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions.

Symptoms of the disorder include excessive washing or cleaning, repeated checking, extreme hoarding, preoccupation with sexual, violent or religious thoughts, relationship-related obsessions, aversion to particular numbers and nervous rituals such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms are time-consuming, might result in loss of relationships with others and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic; however, people with OCD generally recognise their obsessions and compulsions as irrational and may become further distressed by this realisation.

People with OCD are often reluctant to seek help because they feel ashamed or embarrassed.

With treatment, however, the outlook for OCD is good. Many people will eventually be cured of their OCD, or their symptoms will at least be reduced enough that they can enjoy a good quality of life.

The main treatments for OCD are:

cognitive behavioural therapy (CBT) – involving a therapy known as graded exposure with response prevention (ERP), which encourages you to face your fear and let the obsessive thoughts occur without "neutralising" them with compulsions

selective serotonin reuptake inhibitors (SSRIs) – this medication can help reduce your symptoms by altering the balance of chemicals in your brain